Sadé J, Luntz M
Department of Otolaryngology, Meir Hospital, Kfar Saba, Israel.
Ann Otol Rhinol Laryngol. 1989 May;98(5 Pt 1):355-8. doi: 10.1177/000348948909800508.
Thirteen atelectatic ears were politzerized with CO2, O2, air, and N2. In consequence, the atelectasis in these ears disappeared, only to reappear again slowly. The reappearance of retraction corresponded in speed to the diffusion coefficient of the gases, indicating a regular diffusion process. At the same time, four of these politzerized patients were able to collapse the tympanic membrane of their air-filled middle ears abruptly through sniffing or swallowing. At least three patients could introduce air actively and voluntarily into their ears. These observations indicate that in atelectatic ears, as in normal ears, air can enter and leave the middle ear through one of two routes. One is the eustachian tube, through which air can pass both ways as a bolus. The second route is through the bloodstream, which gases enter and leave according to the rules of biologic diffusion. While the origin of negative pressure in atelectatic ears is unknown, this study shows that it may be a complex process stemming from a quantitative imbalance of loss versus gain of gas entry through either of the two routes.
对13只肺不张的耳朵进行了二氧化碳、氧气、空气和氮气的波利策尔氏吹张法治疗。结果，这些耳朵中的肺不张消失了，但又慢慢再次出现。回缩的再次出现速度与气体的扩散系数相对应，表明这是一个正常的扩散过程。与此同时，这些接受波利策尔氏吹张法治疗的患者中有4人能够通过吸气或吞咽突然使充满空气的中耳鼓膜塌陷。至少有3名患者能够主动且自愿地将空气引入耳中。这些观察结果表明，在肺不张的耳朵中，与正常耳朵一样，空气可以通过两种途径之一进出中耳。一种是咽鼓管，空气可以作为一团气体双向通过。第二条途径是通过血液循环，气体根据生物扩散规律进出。虽然肺不张耳朵中负压的起源尚不清楚，但这项研究表明，它可能是一个复杂的过程，源于通过这两种途径之一进入的气体损失与获得的数量失衡。
